COVID-19 Vaccination Guidelines — United States (August 2025)

Intro

As of late August 2025, COVID-19 vaccine policy in the U.S. is fragmented.
The FDA, CDC, AAP (pediatrics), and ACOG (obstetrics) are not fully aligned, creating confusion over who should be vaccinated, when, and at what cost.

Key Points

FDA: Approved updated vaccines targeting the LP.8.1 strain (an offshoot of JN.1) for limited groups.
CDC: Narrowed recommendations to high-risk patients; advisory committee replaced.
AAP: Recommends vaccination for infants 6–23 months, and for older children at risk.
ACOG: Recommends updated vaccination for all pregnant and lactating patients.
Coverage: Insurance may be patchy without ACIP recommendations; private cost ~$140+ per dose.

FDA Approvals (Aug 27, 2025)

Pfizer-BioNTech (Comirnaty): 65+; ages 5–64 with ≥1 underlying condition.
Moderna (Spikevax): High-risk individuals aged 6 months+.
Novavax: High-risk individuals aged 12+.

CDC Position

No longer recommends universal vaccination.
“Shared clinical decision-making” for healthy children and adults.
Advisory committee (ACIP) removed in June 2025; new members pending.

AAP Position (Pediatrics)

Infants 6–23 months: Strong recommendation to vaccinate.
Ages 2–18: Recommend if high-risk, unvaccinated, or living in congregate/high-risk settings.

ACOG Position (Pregnancy)

Recommends updated COVID-19 vaccine:
- At any trimester of pregnancy.
- During postpartum or lactation.

Coverage and Costs

Without ACIP endorsement, insurers may not cover all populations.
Private sector cost: estimated at ~$140 per dose.
Vaccines for Children (VFC) program may not cover outside FDA high-risk indications.

Risks / Benefits / Prognosis

Vaccines remain strongly protective against severe disease in high-risk groups.
Benefit for healthy children and young adults is debated.
Ongoing political conflict may undermine clarity and access going into winter 2025–26.

FAQ

Q: Can healthy kids still get vaccinated?
A: Yes, if a doctor agrees, but coverage may be limited and parents may face out-of-pocket costs.

Q: Do pregnant women qualify?
A: Yes. ACOG recommends vaccination during pregnancy, postpartum, and lactation.

Q: Which variant do the new vaccines target?
A: LP.8.1, an offshoot of JN.1.